Live to Lead

Full Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number *

E-mail *

example@example.com

Business *

example@example.com

Business:

Title/position:

Title/position *

example@example.com

How did you hear about us? *

Any special requirements *

Would you be willing to recommend us?

Yes Maybe Not now

If yes, please give reference of any two people whom you feel would benefit from attending:

	Full Name	Email	Contact Number
1
2

My Products

L2L Ticket

$ 99.00

L2L Table Table of 6

$ 600.00

L2L Value Sponsor • Table of 6 at event w/ logo branding in center of table • Business logo on slide shown during breaks • Business logo in the conference program • Business logo on Siouxland Magazine website/L2L page – with hyperlink • Business logo on Siouxland Magazine Facebook page & Linked In • Stage mention from emcee

$ 1,500.00

Partnering Sponsor • Table of 8 at event w/ logo branding in center of table – placement at front of room • Business logo on slide shown during breaks • One slide (designed by you) to rotate on slide show during breaks • Business logo in the conference program • Business logo on Siouxland Magazine website/L2L page • Business logo on Siouxland Magazine Facebook page & Linked In • One Quarter-page ad in November issue of Siouxland Magazine ($400 Value) • Shoutout on radio advertisements (Powell) • Stage mention from emcee

$ 2,200.00

Total

$ 0.00

Credit Card

Registration:

Credit Card